允许性高碳酸血症在新生儿呼吸窘迫综合征治疗中的应用  

Lung protective strategies of ventilation in respiratory distress syndrome of neonates.

作　　者：杨秀芳[1] 郑铠军[1] 邓向红[1] 夏荣华[1] 陈敬国[1] 陈简[1] 黄惠娟[1] 

机构地区：[1]广东省中山市人民医院,中山528403

出　　处：《中华妇幼临床医学杂志（电子版）》2006年第2期86-88,共3页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨允许性高碳酸血症肺保护性通气策略对降低呼吸窘迫综合征新生儿(NRDS)呼吸机相关性肺损伤的价值。方法将2003年1月至2005年6月收住我院应用呼吸机支持治疗的NRDS 60例患儿,随机分为实验组和对照组,实验组30例应用肺保护性通气策略,对照组30例应用传统通气方式,比较两组呼吸机设置、血气分析结果、呼吸机相关性肺损伤指标。结果实验组呼吸机相关性肺损伤发生率3．33％,显著低于对照组的20．00％(P<0．05),实验组血气分析仅PaCO2高于对照组[(49± 5)mm Hg vs(38±4)mm Hg](P<0．05),动脉导管开放、脑室内出血发生率以及呼吸机应用时间、用氧时间、住院天数差异两组均无显著意义,而实验组病死率低于对照组(P<0．05)。结论在NRDS中应用肺保护性通气策略,可降低呼吸机相关性肺损伤发生率,降低NRDS患儿死亡率。Objective To investigate the advantages of protective ventilation strategies in NRDS and the value of decreasing the incidence of ventilator-associated lung injury （VALI）. Methods 60 NRDS neonates who needed ventilator support during 2003 to 2005 were divided into two groups randomly, the experimental group （n = 30） using protective ventilation strategies and the controlled group （n= 30） with traditional ventilation strategies. The ventilator settings, artery blood gas analysis, ventilator-associated lung injury and other clinical data were collected and analyzed. Results The incidence of VALI in experimental group was significantly lower than that in controlled group （3.33% vs 20. 00%, P〈0. 05）. PaCO2 in experimental group was significantly higher than controlled group （P〈0. 05）. No differences were found between the two groups regarding to the length of ventilator support, length of supplemental oxygen requirements, length of hospitalization, incidence of PDA and IVH. The mortality in the experimental group was significantly lower than that in controlled group （P〈0. 05）. Conclusions The protective ventilation strategies can decrease the incidence of VALI and the mortality in NRDS neonate.

关 键 词：保护通气 通气策略 新生儿 呼吸窘迫综合征 

分 类 号：R722.1[医药卫生—儿科]